Millions of people around the world suffer from chronic disorders of sleep that interfere with work, daily life, and social activities. Sleep disorders are responsible for numerous cardiovascular deaths and cost billions of dollars annually in healthcare expenses and lost productivity at work.

Insomnia is a sleep disorder that refers to nightly or near-nightly complaints of insufficient amount of sleep or not feeling rested after sleeping. Insomnia is associated with an increased incidence of disease and fatality.

The ideal treatment for insomnia should improve sleep quantity and quality, improve daytime functioning (greater alertness and concentration) and cause minimal adverse effects.

Most experts recommend starting with non-pharmacologic therapy for insomnia. There is good scientific evidence to support the benefits of relaxation therapy and cognitive-behavioral therapy that can be sustained for 6-24 months. In addition, exercise is highly recommended in patients with insomnia.

Biofeedback and progressive muscle relaxation, along with other non-pharmacologic strategies are effective insomnia treatments and are recommended by the American Academy of Sleep. More recently, it has been observed that people with a sleep disorder who underwent 15 to 20 sessions of Neurofeedback training became “normal sleepers” with significantly improved nighttime sleep and daytime functioning.^1,2,3

References:
1. Ramakrishnan K, Scheid DC, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, Treatment Options for insomnia, Am Fam Physician. 2007 Aug 15;76(4):517-526.)
2. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 185
3. Morganthaler, T., Kramer, M., Alessi, C., Friedman, L., Boehlecke, B., & Brown, T. (2006). Practice parameters for the psychological and behavioral treatment of insomnia: An update. An American Academy of Sleep Medicine report. Sleep: Journal of Sleep and Sleep Disorders Research, 29 (11), 1415–1419.

Attention is a basic component of brain function that allows us to process information in our environment and select appropriate stimuli. It is the basis for maintaining concentration, without which coherent thought is not possible. In other words, attention is the process that allows a person to focus and concentrate on one thing and ignore competing influences that are distracting or irrelevant.¹

Attention deficit disorder (ADD) with or without hyperactivity (ADHD) is one of the most common neurobehavioral disorders encountered in clinical practice. It is a genetic, mind-based syndrome that affects the regulation of specific brain functions and related behaviors. Individuals with ADD/ADHD have problems with attention, concentration, memory, motivation, and effort. There may also be an inability to learn from mistakes, impulsivity, hyperactivity, and disorganization. People with ADD/ADHD often lack social skills and suffer from anxiety and mood disorders as well as substance use disorders.^2,3

Several psychological and physiological conditions can mimic ADD/ADHD behaviors, including anxiety, depression, attachment disorders, head injuries, thyroid dysfunction, low iron, and various other conditions. The brainwave assessment that takes place during Neurofeedback helps us recognize and flag different areas of the brain that are associated with various types of inattentiveness and rule out other causes of brain impairment.⁴

Recent studies suggest that individuals with ADD/ADHD who receive Neurofeedback therapy experience a sustained reduction in symptoms over time compared to non-active control conditions. Neurofeedback can thus be considered an effective non-pharmacological treatment option for attention deficit disorders. Scientific evidence suggests that the positive effects of Neurofeedback are sustained beyond treatment completion. In terms of measuring treatment effectiveness, Neurofeedback has been found to have long-term effects lasting 3 to 6 months and appears to offer similar effects to medication for inattention and impulsivity.^5,6

References:
1. Thompson Dr., The Neurofeedback Book, P660
2. Wilens TE, Spencer TJ, Understanding Attention-Deficit/Hyperactivity Disorder from Childhood to Adulthood, PMC 2013 July 26
3. U.S. Department of Health and Human Services National Institutes of Health NIH Publication No. QF-16-3572 Revised 2016
4. Swingle PG, Biofeedback for the brain, 2008, 127-143
5. Van Doren J, Arns M, Heinrich H, Vollebregt MA, Strehl U, Loo SK, Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis, received: 5 October 2017 / Accepted: 5 February 2018 / Published online: 14 February 2018
6. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 174

Burnout is a psychological reaction to chronic work stress. The estimated prevalence of severe burnout ranges from 2 to 13% in representative working populations.

The concept of burnout originated in human service professionals for whom the majority of work tasks involve interactions with employees, which can lead to stress. In such individuals, burnout can manifest with depersonalization, emotional exhaustion, and diminished accomplishments. Other common burnout symptoms include cynicism, exhaustion, and poor work efficacy.

Studies have found that burnout can increase the risk of diabetes, heart disease, infections, aches and pains, and depression. In addition, burnout can increase the risk of severe injuries, sickness absence, disability pension and even premature death.

Despite extensive research on the predisposing factors and consequences of burnout, there is a lack of consensus on treating this condition.¹ Currently, there is no specific effective treatment for burnout syndrome; however, more leisure time, regular physical activity, and distancing from the source of stress can help improve symptoms.²

As part of Biofeedback and Neurofeedback for burnout, tools and training are used that are proven to be effective in stress management. These approaches are extremely efficient, considering that burnout is a severe form of stress and anxiety.

References
1. Ahola K, Toppinen-Tanner S, Seppanen J, Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: systematic review and meta-analysis (link)
2. Gerber M, Isoard-Gautheur S, Schilling R, Ludyga S, Brand S, College F, When Low Leisure-Time Physical Activity Meets Unsatisfied Psychological Needs: Insights From a Stress-Buffer Perspective, Front. Psychol., 02 November 2018, (link)

Over the past three decades, interest in optimal performance has skyrocketed among researchers, medical practitioners, athletes, and performers. However, despite this increasing interest, elite-level performance or performing “in the zone” continues to be elusive for many individuals.¹

One of the benefits of Neurofeedback is optimal performance or peak-performance training.

If a person wants to be physically fit, they might visit the gym a few times each week. For peak athletic performance, however, they would need to put in additional work. Optimal brain functioning is a key contributor to peak performance. Keeping the brain in the upper ranges of operation requires systematic and frequent training sessions.

Champion athletes have proven that Neurofeedback can be a great help with keeping the brainwaves in a healthy and prepared state, leading to more control over reactions, staying calm and focused, having better reaction times, and achieving deeper states of creativity, recovery and satisfaction.² In other words, efficiency and peak performance can be achieved by using the right brainwave at the right time for the right task.³

References:
1. Harmison RJ, Casto KV, Optimal performance: elite level performance in the zone, The Oxford Handbook of Sport and Performance Psychology, Print Publication Date: Aug 2012, Subject: Psychology, Health Psychology Online Publication Date: Nov 2012, DOI:10.1093/oxfordhb/9780199731763.013.0038
2. Swingle PG, Biofeedback for the brain, 2008, p121-123
3. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 149-150

Occasional anxiety is not unusual or abnormal. Everyone worries about their health, family, or money from time to time. However, individuals with a generalized anxiety disorder (GAD) experience extreme worry or nervousness about a variety of things although there is no real reason to worry. In other words, individuals with GAD are unable to control feelings of anxiety and unable to focus on work and daily activities.

Generalized Anxiety Disorder develops gradually. Individuals with this condition can have the following symptoms:  

– Excessive worry about unimportant things
– Inability to control worries or nervousness
– Restlessness or inability to relax
– Trouble concentrating
– Easily frightened
– Sleep difficulties
– Persistent fatigue or tiredness
– Unexplained aches and pains

Psychotherapy and medications are the two most common treatments used for Generalized Anxiety Disorder. However, anti-anxiety medications can only be used for a short period and may be accompanied by unwanted side effects and the risk of addiction.¹

Research has shown that Biofeedback and Neurofeedback therapies for the management of Generalized Anxiety Disorder in adults can lead to a reduction in symptoms and a significant increase in the level of functioning. Several types of anxiety disorders can benefit from Biofeedback and Neurofeedback including generalized anxiety, phobias, obsessive-compulsive, post-traumatic stress, and panic disorders.^2,3 

References:
1. U.S. Department of Health and Human Services, National Institutes of Health, Generalized Anxiety Disorder, NIH Publication No. 19-MH-8090 Revised 2016
2. Thomas JE, Sattlberger E, Treatment of Chronic Anxiety Disorder with Neurotherapy, Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience, 2:2, 14-19, DOI: 10.1300/J184v02n02_03
3. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 175-176

It is normal to be frightened during and after dangerous events. Experiencing fear is the human body’s natural defense mechanism and “fight-or-flight” survival instinct. It is critical for avoiding and responding appropriately to possible dangers. Different people have different responses to trauma. Most individuals overcome it and have no symptoms after the passage of time. However, sometimes an individual may develop post-traumatic stress disorder (PTSD) following a frightening, disturbing, or alarming event. Individuals who have persistent symptoms long after the event is over may receive a diagnosis of PTSD.

A key characteristic of PTSD is feeling scared or stressed even after the danger has passed. It is worth noting that every individual with PTSD does not go through the trauma themselves. In some instances, the traumatic experience of a family member or friend can lead to PTSD.¹

Research in both animals and humans has shown that early emotional trauma can lead to structural changes in the brain and the nervous system and cause behavioral and physiological changes. These changes occur to protect the individual’s mind and body in the present and the future. Therefore, PTSD is not a disease, rather it is a compensatory response of the incredibly complex human nervous system.²

Medications and cognitive-behavioral therapy are two common treatments used in those with PTSD.

Recently, Biofeedback and Neurofeedback therapies have shown to promote true brain healing using neuroplasticity to train specific areas of the brain or entire neuronal networks. Treatment for PTSD should, include nutrition, psychotherapy, (perhaps paired with Eye Movement Desensitization and Reprocessing (EMDR)), exercise, group interaction, Biofeedback and Neurofeedback.³ EMDR is a form of psychotherapy originally designed to alleviate the distress associated with traumatic memories.⁴

References:
1. U.S. Department of Health and Human Services, National Institutes of Health, Post-Traumatic Stress Disorder, NIH Publication No. 20-MH-8124 Revised 2020
2. Thompson Dr, The Neurofeedback book, P 690
3. Thompson Dr, The Neurofeedback book, P 684, 685
4. Francine Shapiro, Eye Movement Desensitization and Reprocessing, Third Edition, 2018, P 24

“Depressive disorder” is a mood disorder that causes distressing symptoms that affect the individual’s feelings, thoughts, and daily activities like working, eating, and sleeping.

Research suggests that depression is the result of a combination of biological, genetic, psychological, and environmental factors. Symptoms of depression include:¹

– Persistent feelings of sadness, anxiety, or “emptiness”
– Feelings of pessimism or hopelessness
– Feelings of helplessness, worthlessness, or guilt
– Lack of interest in activities and hobbies
– Fatigue or reduced energy
– Restlessness or irritability
– Difficulty with concentration, memory, and decision-making
– Sleep disturbances, such as insomnia, excessive sleeping, or early-morning awakenings
– Increase or decrease in appetite/weight
– Thinking about death or suicidal ideation
– Headaches, muscle aches, or digestive symptoms with no obvious cause that fail to get better with treatment

Research has shown that Alpha symmetry training and Beta training in the frontal brain are effective in improving depression symptoms.²

“Bipolar disorder” is a mental health condition that is chronic and episodic, meaning that it occurs unpredictably at erratic intervals. Individuals with this condition can experience extreme fluctuations in energy, mood, concentration, and activity levels.

A person with bipolar disorder can feel incredibly happy or “up” with a dramatic escalation in activity level during manic episodes. During depressive episodes, the person may experience indifference, sadness, or hopelessness along with extremely low levels of activity.  Some bipolar individuals experience hypomania, which is similar to manic episodes, although not as severe or disruptive.

Scientists have not identified an exact cause for this condition. Research indicates that there is not one single cause. Rather, multiple factors can contribute to bipolar disorder, including a genetic predisposition and differences in brain structure and function.

Bipolar disorder is a treatable condition. It can be managed with medications, psychotherapy, or a combination of the two. Some people do respond to these treatments, but the long-term benefits are not overly impressive.³

Neurofeedback has shown particularly good results in individuals with bipolar disorder. In many bipolar patients, the amount of medication can be reduced as a result of self-regulation and improvement in emotional control with Neurofeedback training.^4,5

References:
1. U.S. Department of Health and Human Services, National Institutes of Health, Depression Basics, NIH Publication No. 19-MH-8079 Revised 2016
2. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 177-178
3. U.S. Department of Health and Human Services, National Institutes of Health, Bipolar Disorder, NIH Publication 19-MH-8088 Revised October 2018
4. Swingle PG, Biofeedback for the brain, 2008, p160
5. Thompson Dr, The Neurofeedback book, P 647

Fibromyalgia is a confounding and often unrecognized and under-treated medical condition that affects 2 out of every 100 people. In many individuals, fibromyalgia is present along with other functional somatic medical conditions like chronic fatigue syndrome, irritable bowel syndrome, and TMJ (temporomandibular joint) dysfunction (jaw pain).

Fibromyalgia is characterized by features of generalized pain and tenderness in the deep tissues as a result of sensitivity in the neural pain pathways. In addition, there may be various combinations of sleep problems, fatigue, psychological distress, and cognitive decline. The symptoms are present without any objective findings on clinical evaluation. It likely represents a maladaptive biological response to accumulated psychological and physical stress in genetically predisposed individuals.

Spontaneous recovery is unusual and therefore, the aim of fibromyalgia management is to improve symptoms, functioning, and quality of life. Treatment is multimodal, multidisciplinary and combines mainly non-pharmacological but occasionally also pharmacological approaches.¹

There is an extensive body of research on chronic pain that has shown Biofeedback and Neurofeedback are as effective as conventional treatment with medications and generally more effective than no-treatment control groups.

A randomized, controlled study found that Neurofeedback is effective in improving pain, psychological symptoms, and impaired quality of life in people with fibromyalgia. Since chronic pain can have a specific focus or be widespread, both generalized and focused approaches are effective. Overall, there is a statistically significant positive outcome and efficacy of Biofeedback and Neurofeedback for chronic pain.²

Extensive research has also been conducted on the efficacy of Biofeedback and Neurofeedback interventions for tension, migraine, and mixed headaches with strongly positive results. A recent study of Neurofeedback and Biofeedback in individuals who suffer from migraines found that 70% of the patients experienced at least a 50% reduction in headaches compared to medication-alone treatment.²

References:
1. Kwiatek R, Treatment of Fibromyalgia, Aust Prescr 2017;40:179–83 https://doi.org/10.18773/ austprescr.2017.056
2. Chapin TJ, Russell-Chapin LA, Neurotherapy and Neurofeedback Brain-Based Treatment for Psychological and Behavioral Problems, 2014, p 183